Percutaneous transluminal renal stenting for transplant renal artery stenosis

Sharma, Satyavan; Potdar, Anil; Kulkarni, Amit

doi:10.1002/ccd.22758

Cited by 15 publications

(18 citation statements)

References 10 publications

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“…TRAS is one possible cause of refractory hypertension and allograft dysfunction, accounting for 1–5% of patients with hypertension after transplantation . In our study, 72.7% of patients had graft dysfunction and 81.8% had refractory hypertension.…”

Section: Discussionmentioning

confidence: 46%

“…Percutaneous interventional therapy is widely accepted as a viable therapy for TRAS . However, the benefits of endovascular interventional therapy to correct TRAS remain controversial.…”

Section: Introductionmentioning

confidence: 99%

“…However, the benefits of endovascular interventional therapy to correct TRAS remain controversial. In addition, many studies have reported short‐ or medium‐term efficacy of endovascular intervention . Accordingly, in this study, we retrospectively evaluated the safety and long‐term efficacy of interventional therapy.…”

Section: Introductionmentioning

confidence: 99%

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Endovascular management of transplant renal artery stenosis: A single‐center retrospective study

Ren

Xiong

Kan

et al. 2019

Cathet Cardio Intervent

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Objectives The aim is to evaluate the efficacy and complications of percutaneous transluminal angioplasty (PTA)/stenting in the treatment of transplant renal artery stenosis (TRAS). Background TRAS is a relatively rare condition, and currently, there is not enough study about interventional therapy for TRAS. Methods Between April 2011 and July 2018, 33 patients with TRAS underwent interventional therapy. Analysis of parameters was as follows: technical success, pretreatment and posttreatment serum creatinine, and blood pressure, and vessel patency via ultrasound at 1, 6, and 12 months posttreatment and once a year thereafter. Results One procedure failed. The success rate of PTA/stenting placement was 97.0%. Fourteen PTAs with 16 stents were primary interventions, with 2 stent procedures performed subsequently due to restenosis; the restenosis rate was 6.3%. During the follow‐up period, two patients progressed to graft renal failure and three patients were lost to follow‐up. The rest of the patients still had stable graft function and blood pressure. Compared with preoperative conditions, blood pressure and serum creatinine significantly decreased (p < .05). No treatment‐related deaths or serious complications occurred. Conclusions PTA/stenting is a safe and effective treatment for TRAS. For selected TRAS patients, PTA or PTA with stent may achieve good therapeutic outcomes. Selecting appropriate puncture pathways may help improve the success rate and affect the operation results, and open surgery may be avoided.

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Section: Discussionmentioning

confidence: 46%

“…Percutaneous interventional therapy is widely accepted as a viable therapy for TRAS . However, the benefits of endovascular interventional therapy to correct TRAS remain controversial.…”

Section: Introductionmentioning

confidence: 99%

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Endovascular management of transplant renal artery stenosis: A single‐center retrospective study

Ren

Xiong

Kan

et al. 2019

Cathet Cardio Intervent

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“…As discussed in other studies, technical success rate of PTA in treatment of Prox-TRAS is recorded to reach 95% while its 3- to 5-year patency rates range from 75% to 90% [17]. In comparison to open surgery, PTA has been documented to carry lower morbidity and mortality rate and has been established as first-line treatment of significant arterial stenosis of transplant recipients when it is viable [18]. …”

Section: Discussionmentioning

confidence: 99%

Close to Transplant Renal Artery Stenosis and Percutaneous Transluminal Treatment

Leonardou

Gioldasi

Pappas

2011

Journal of Transplantation

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Purpose. To evaluate the efficacy of percutaneous transluminal angioplasty (PTA) in the management of arterial stenosis located close to the allograft anastomosis (close-TRAS). Materials and Methods. 31 patients with renal transplants were admitted to our institution because of persistent hypertension and impairment of transplant renal function and underwent angiography for vascular investigation. 27 were diagnosed suffering from transplant renal artery stenosis (TRAS), whereas 4 had severe iliac artery stenosis proximal to the transplant anastomosis (Prox-TRAS). 3 cases of TRAS coexisted with segmental renal arterial stenosis, whereas 3 other cases of TRAS were caused by kinking and focal stenosis in the middle of the transplanted renal artery. Results. Angioplasty and stenting were successfully applied to all patients with iliac artery stenosis as well as to those with TRAS and segmental artery stenosis. Two of three patients with kinking were well treated with angioplasty and stenting, whereas one treated only with angioplasty necessitated surgery. No major procedure-related complications appeared, and the result was decrease of the serum creatinine level and of the blood pressure. Conclusions. PTA is the appropriate initial treatment of TRAS and close-TRAS, with low morbidity and mortality rates, achieving improvement of graft function and amelioration of hypertension.

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“…These studies raised skepticism about renal revascularization among physicians and payors, leading some to recommend therapeutic nihilism [6]. In contrast, in this issue of Catheterization and Cardiovascular Interventions, Sharma et al demonstrate unequivocal benefit of renal revascularization for transplant renal artery stenosis (TRAS) [7]. What lessons should we learn from this study?…”

mentioning

confidence: 98%

Transplant renal artery stenosis: What lessons should we learn?

Safian

2011

Cathet Cardio Intervent

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Percutaneous transluminal renal stenting for transplant renal artery stenosis

Abstract: Percutaneous renal stenting provides excellent angiographic and clinical results sustained at intermediate term follow-up in patients with symptomatic transplant renal artery stenosis.

Cited by 15 publications

References 10 publications

Endovascular management of transplant renal artery stenosis: A single‐center retrospective study

Endovascular management of transplant renal artery stenosis: A single‐center retrospective study

Close to Transplant Renal Artery Stenosis and Percutaneous Transluminal Treatment

Transplant renal artery stenosis: What lessons should we learn?

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